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DG DISPATCH - AAN: Melatonin helps kids with sleep-onset insomnia By Richard Robinson Special to DG News SAN DIEGO, CA -- May 2, 2000 -- Melatonin is an effective treatment for sleep-onset insomnia in children, according to a study presented Monday (May 1) at the 52nd Annual Meeting of the American Academy of Neurology. Melatonin has been shown to advance sleep onset in adults with sleep-onset insomnia and delayed sleep-wake rhythm, according to study leader Marcel Smits, MD, of the Hospital de Gelderse Vallei, in Edes, the Netherlands. To test melatonin's ability to provide the same benefit in children, Dr. Smits and colleagues tested 70 children ages six to 12, who had chronic sleep-onset insomnia, defined as sleep onset more than one hour after normal for more than one year. The 44 boys and 26 girls were randomly assigned to receive either placebo or 5 mg melatonin at 6 PM for four weeks. During a one-week baseline and again during treatment week 4, lights-off time, sleep-onset time, and wake-up time were recorded by diary. Actigraphy was also used to determine sleep onset. The placebo group showed no change on any of the measured parameters. In contrast, in the treated group, lights-off time advanced a mean of 27 minutes (from 9:33 PM to 9:06 PM), sleep onset advanced more than one hour (from 10:36 PM to 9:33 PM), and wake-up time advanced 22 minutes (from 7:43 AM to 7:21 AM). Measurement of salivary melatonin levels confirmed an advance in the onset of the evening elevation of more than one hour (from 9:03 PM to 7:51 PM). There was no significant effect on sustained attention time, as measured by the Bourdon-Vos test. Five of the treated children reported side effects during the first two days of melatonin treatment, including headache, dizziness, and malaise. Dr. Smits noted that while the study included 38 children with attention-deficit hyperactivity disorder, the results of the study were independent of this diagnosis, and remained unchanged when analysis without this subgroup was conducted. "Melatonin was significantly more effective than placebo in advancing sleep onset," Dr. Smits said. "Sleep improves without affecting daytime sustained attention." He also noted that parents reported the treatment was "like having a different child." The study was titled, "Melatonin for chronic sleep onset insomnia in children: Randomized placebo-controlled study." E-mail this page to a friend or colleague! To print, use this version